Digital Single Market – Commission at crossroads in development of digital health

The scope of the European Commission’s Digital Single Market (DSM) strategy is certainly ambitious: copyright, geo-blocking and online shopping are all covered, with the aim of helping consumers and businesses to realise the potential of the digital revolution.

Dig a little deeper, and you also find numerous references to digital health. This is a welcome move, after more than three years of inactivity since the publication of the eHealth Action Plan 2012-2020, the second roadmap to support the development of digital health (eHealth). But at the moment, the strategy is heavy on analysis of the problems, and light on solutions.

In its DSM strategy, launched by the Commission Vice President for the Digital Single Market, Andrus Ansip (pictured), and the Commissioner for the Digital Economy and Society, Günther Oettinger, the Commission reminds us that digital solutions can empower citizens to manage their health.

Connected watches, wearables and health devices have the potential to profoundly reshape our health systems. Health and care systems can improve their efficiency and cope with the increasing demands from an ageing population.

However, the development of eHealth systems differs between member states and the case for eHealth is still hard to make.

On health, the Commission acknowledges in the DSM strategy that it has a lot to do to create the right conditions for the uniform development of telemedicine. Electronic health systems are still too fragmented and EU-wide standards are still missing. Systems are too specific and national and uptake is limited – so businesses adopt a wait-and-see approach instead of investing.

The eHealth Network, a group created by the Commission to improve discussion among member states on issues such as interoperability, has not managed to push standardisation as far or as fast as expected. The Commission has funded several projects on the topic in its last two research programmes, but these were too small to have a significant impact on the development of eHealth networks.

Healthcare providers will be key to the development of digital health, according to the Digital Single Market strategy. However, the 2013 Commission study on Benchmarking Deployment of eHealth among general practitioners shows that doctors are sceptical about the benefits of eHealth.

The DSM strategy also focuses on the future framework for data protection. Flexible rules to share health data could support health research as well as research into personalised treatments, with models based on real-life studies. But the protection of personal information is highly sensitive across Europe. Consensus is hard to find.

Major impediments to the development of digital health also lie beyond these technical issues.

The EU has limited powers regarding the organisation of member states’ health systems. In general, the Commission recommends, but member states decide.

In addition, digital health requires financial investment – something that is all the more difficult in the current climate of deficits and sluggish (or non-existent) growth. Nevertheless, member states, the European Parliament and the Commission see eHealth as an opportunity to achieve savings in a time of pressure on health systems.

There is a significant industrial growth potential in this field, with the 2012 Action Plan noting that the global eHealth market could be worth US$27.3bn in 2016. Patients are more eager than ever to reap the benefits of cross-border healthcare and greater integration of mobile health (mHealth) applications with other digital appliances.

Despite the limitations encountered over recent years, the Commission still sees a digital future for health systems in Europe. In recent country-specific reports under the European Semester process, moves towards eHealth systems are strongly advocated as a means of delivering cost-effectiveness and growth. However, cautious governments might look to the United Kingdom’s failed €17bn National Health Service ‘Connecting for Health’ electronic records system and hesitate about large digital health projects.

Is digital health another of those areas where ambitions fail to be matched by practical implementation; where the fragmentation of Europe appears too difficult to overcome?

The answer to that question is likely to depend upon the ambitions of Ansip and Oettinger (pictured).

Ansip, an Estonian, knows well the potential benefits of digital solutions for government, but can he overcome the barriers which prevent such solutions from being realised on a much larger scale, across Europe and for the benefit of all Europeans?


Words  Thomas Kanga-Tona
Photos  (c) European Union 2015; Wikimedia Commons – Intel Free Press

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